CARE GIVER’S GUIDE

PAIN CAN MOTIVATE CHANGE
Many godly parents have prayed and fasted for their child or a loved one, yet they watch painfully as the person continues down a path of rebellion and destruction. One mother said,”I pray for my children, but why is God so slow to answer?” So what can parents or grandparents do to help their loved ones? For many, the key is to stop enabling the behavior of their loved one by continually rescuing them from the consequences of their actions. Once the loved one begins to feel the pain they are creating through drug abuse or other destructive behavior, the path to health and wholeness can emerge as an alternative to the path of destruction.

ARE YOU AN ENABLER? TAKE THIS TEST:

Works for self-improvement: ” If I were a better parent/grandparent/friend, my loved one wouldn’t be doing this.”

Changes the environment to accommodate the person with the problem: ” Let’s change schools and get our child away from those troublemakers.”

Takes on the whole world in defense of a loved one: ” The whole legal system is corrupt, and my child/grandchild/friend is getting unjust treatment.”

Their pain increases. Because the loved one is still acting irresponsibly, the enabler’s pain and frustration deepens.

Communication deteriorates. Because the issues are unresolved, defenses are high. Both the enabler and the loved one are often deluded about reality.

Enabling is habit-forming. The enabler keeps offering the same kind of help. Sometimes the enabler derives such deep satisfaction from “rescuing” someone that he or she never assesses whether the assistance is helping or hurting the loved one.

ENABLING – OFFERING THE WRONG KIND OF HELP
Enabling is rescuing your loved ones so that they do not experience the painful consequences of their irresponsible decisions. Enabling is anything that stands in the way of persons experiencing the natural consequences of their own behavior. Tracy, the young mother of two boys, has mastered the art of manipulating her family into enabling her behavior. Often arrested on drug charges, she would say to her parents, “Do you want to see the mother of your grandchildren locked up in jail?” The last time it happened , the parents were planning to mortgage their home so they could afford the bail payment.

Galatians 6:7-8 speaks to Christians about this with a simple but blunt truth. “Do not be deceived: God cannot be mocked. A man reaps what he sows. The one who sows to please his sinful nature, from that nature will reap destruction; the one who sows to please the Spirit, from that Spirit will reap eternal life.”(NIV) Bad actions have painful consequences, even when our children or loved ones are involved. Thankfully, God can use those consequences for His purposes if we don’t get in His way.

When you stop enabling, get ready for more trouble. When you stop offering the wrong kind of help, your loved ones may get very angry with you – and for a “good” reason. You’ve stopped rescuing them. Now they are beginning to feel the painful consequences of their irresponsible decisions. Just before mortgaging their home, Tracy’s parents were persuaded to stop enabling her. They let her stay in jail for almost a year, feeling the full impact of her irresponsible behavior. Angry and frustrated, Tracy accused them of not loving her. But while she was in jail, the drugs cleared out of Tracy’s system and she began to think clearly again. She joined a Bible study, became a Christian and entered Teen Challenge when she was released.

When you make a decision to stop enabling, like Tracy’s parents did, you must stand on the facts, especially if you have a tender heart. You must continue to rehearse the fact of how your loved one’s actions are destroying his or her life and how enabling this to continue is the worst thing you could do.

God is a loving Father, don’t be afraid to trust Him. When you stop enabling your loved one, he or she may go further down the path of destruction. You may inwardly think, “I can’t bear to see my daughter in such pain and danger.” Or, “My son might get killed! And then I would have his death on my hands. I can’t let that happen!”

But whatever happens, do not be afraid to trust God. Place your hope in the story of the Prodigal Son recorded in Luke 15. This father did not enable his son. He allowed him to leave home, knowing the son would soon waste his inheritance. Before long, the rebellious young man had lost everything, and he ended up in a pig pen eating the food the pigs didn’t want.

But all alone in the pig pen, the Bible says, “He came to his senses.” The young man realized that even the hired men at his father’s household ate better than he did. And the son resolved to go and seek his father’s forgiveness. When he finally meets his father again, the son’s true repentance is seen in his words: “Father, I have sinned against heaven and against you.” (Verse 21) He takes personal responsibility for his actions. It’s time for joyful peace and a celebration.

Learning to be at peace with God. Just like the Prodigal Son’s father, you can rest in the peace that God has the address of your loved ones, no matter how deep they are in sin. His love far surpasses your love. He knows what will work best to bring your loved ones to that point of change. You’ve got to trust God even when things are going from bad to worse. Stop offering the wrong kind of help. Stop feeding the problem. Stop being deceived. Trust Him. Jesus is ready to help us offer the right kind of help. He promises to give us wisdom to make the difficult decisions. He also stands ready and waiting with open arms to help our loved ones who really need His help. Look to Him today for guidance on how best to help those you love.

OVERVIEW
Many people do not understand why or how other people become addicted to drugs. It is often mistakenly assumed that drug abusers lack moral principles or willpower and that they could stop using drugs simply by choosing to change their behavior. In reality, drug addiction is a complex disease, and quitting takes more than good intentions or a strong will. In fact, because drugs change the brain in ways that foster compulsive drug abuse, quitting is difficult, even for those who are ready to do so. Through scientific advances, we know more about how drugs work in the brain than ever, and we also know that drug addiction can be successfully treated to help people stop abusing drugs and lead productive lives.

Drug abuse and addiction have negative consequences for individuals and for society. Estimates of the total overall costs of substance abuse in the United States, including productivity and health- and crime-related costs, exceed $600 billion annually. This includes approximately $193 billion for illicit drugs,1 $193 billion for tobacco,2 and $235 billion for alcohol.3 As staggering as these numbers are, they do not fully describe the breadth of destructive public health and safety implications of drug abuse and addiction, such as family disintegration, loss of employment, failure in school, domestic violence, and child abuse.

WHAT IS DRUG ADDICTION?
Addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the addicted individual and to those around him or her. Although the initial decision to take drugs is voluntary for most people, the brain changes that occur over time challenge an addicted person’s self control and hamper his or her ability to resist intense impulses to take drugs.

Fortunately, treatments are available to help people counter addiction’s powerful disruptive effects. Research shows that combining addiction treatment medications with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any co-occurring medical, psychiatric, and social problems can lead to sustained recovery and a life without drug abuse.

Similar to other chronic, relapsing diseases, such as diabetes, asthma, or heart disease, drug addiction can be managed successfully. And as with other chronic diseases, it is not uncommon for a person to relapse and begin abusing drugs again. Relapse, however, does not signal treatment failure—rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

WHAT HAPPENS TO YOUR BRAIN WHEN YOU TAKE DRUGS?
Drugs contain chemicals that tap into the brain’s communication system and disrupt the way nerve cells normally send, receive, and process information. There are at least two ways that drugs cause this disruption: (1) by imitating the brain’s natural chemical messengers and (2) by overstimulating the “reward circuit” of the brain.

Some drugs (e.g., marijuana and heroin) have a similar structure to chemical messengers called neurotransmitters, which are naturally produced by the brain. This similarity allows the drugs to “fool” the brain’s receptors and activate nerve cells to send abnormal messages.

Other drugs, such as cocaine or methamphetamine, can cause the nerve cells to release abnormally large amounts of natural neurotransmitters (mainly dopamine) or to prevent the normal recycling of these brain chemicals, which is needed to shut off the signaling between neurons. The result is a brain awash in dopamine, a neurotransmitter present in brain regions that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this reward system, which normally responds to natural behaviors linked to survival (eating, spending time with loved ones, etc.), produces euphoric effects in response to psychoactive drugs. This reaction sets in motion a reinforcing pattern that “teaches” people to repeat the rewarding behavior of abusing drugs.

As a person continues to abuse drugs, the brain adapts to the overwhelming surges in dopamine by producing less dopamine or by reducing the number of dopamine receptors in the reward circuit. The result is a lessening of dopamine’s impact on the reward circuit, which reduces the abuser’s ability to enjoy not only the drugs but also other events in life that previously brought pleasure. This decrease compels the addicted person to keep abusing drugs in an attempt to bring the dopamine function back to normal, but now larger amounts of the drug are required to achieve the same dopamine high—an effect known as tolerance.

Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate, which can impair cognitive function. Brain imaging studies of drug-addicted individuals show changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control. Together, these changes can drive an abuser to seek out and take drugs compulsively despite adverse, even devastating consequences—that is the nature of addiction.

WHY DO SOME PEOPLE BECOME ADDICTED, WHILE OTHERS DO NOT?
No single factor can predict whether a person will become addicted to drugs. Risk for addiction is influenced by a combination of factors that include individual biology, social environment, and age or stage of development. The more risk factors an individual has, the greater the chance that taking drugs can lead to addiction. For example:

Biology. The genes that people are born with—in combination with environmental influences—account for about half of their addiction vulnerability. Additionally, gender, ethnicity, and the presence of other mental disorders may influence risk for drug abuse and addiction.

Environment. A person’s environment includes many different influences, from family and friends to socioeconomic status and quality of life in general. Factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug abuse and the escalation to addiction in a person’s life.

Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction vulnerability. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to more serious abuse, which poses a special challenge to adolescents. Because areas in their brains that govern decision making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors, including trying drugs of abuse.

PREVENTION IS THE KEY
Drug addiction is a preventable disease. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective in reducing drug abuse. Although many events and cultural factors affect drug abuse trends, when youths perceive drug abuse as harmful, they reduce their drug taking. Thus, education and outreach are key in helping youth and the general public understand the risks of drug abuse. Teachers, parents, medical and public health professionals must keep sending the message that drug addiction can be prevented if one never abuses drugs.

OVERVIEW We, as parents, are the most important role models in our children’s lives. What we say and do about drugs matters a lot when it comes to the choices our children make. We can:

set a positive example and get involved in our children’s lives;

get involved in their activities, know their friends, know where they’re going and what they’re doing;

create clear, consistent expectations and enforce them;

talk early and often about drugs;

discuss the consequences of drug use;

show we care enormously about what choices our children make about drugs.

Children learn by example. They adopt the values we demonstrate through our actions. As they grow, they’re impressed by our concern for others when we bring soup to a sick neighbor and by our honesty when we admit making a mistake.

Although we believe these traits are important, it’s not always easy to be consistent. Telling a friend you’re younger than you really are sends a confusing message to your child — isn’t it wrong to lie? If you forbid smoking in the house, how can you allow your friends to break the rules? If you say that drinking alcohol is a serious matter, how can you laugh uproariously at TV and movie drunks? Because alcohol is off-limits for children, even asking them to fetch a beer from the refrigerator or to mix drinks at an adult party can be confusing.

Children who decide not to use alcohol or other drugs often make this decision because they have strong convictions against the use of these substances — convictions based on a value system. You can make your family’s values clear by explaining why you choose a particular course of action and how that choice reflects your values. If you’re walking down the street together and spot a blind person attempting to cross, you can both offer to help him and then take the opportunity to discuss why it’s important to support those in need. You can also explore moral issues by posing hypothetical questions at the dinner table or in the car — for example, “What would you do if the person ahead of you in the movie line dropped a dollar bill?” or “What would you do if your friend wanted you to skip class with him and play video games instead?” Concrete examples like these make the abstract issue of values come alive.

PLANNING FOR TOGETHERNESS Sometimes it’s frustrating how few chances there are to have conversations about drugs with our children. In our busy culture, with families juggling the multiple demands of work, school, after-school activities, and religious and social commitments, it can be a challenge for parents and children to be in the same place at the same time. To ensure that you have regular get togethers with your children, try to schedule:

Family meetings. Held once a week at a mutually-agreed-upon time, family meetings provide a forum for discussing triumphs, grievances, projects, questions about discipline, and any topic of concern to a family member. Ground rules help. Everyone gets a chance to talk; one person talks at a time without interruption; everyone listens, and only positive, constructive feedback is allowed. To get resistant children to join in, combine the get- together with incentives such as post-meeting pizza or assign them important roles such as recording secretary or rule enforcer.

Regular parent-child rituals. These eliminate the need for constant planning and rearranging. Perhaps you can take the long way home from school once a week and get ice cream or make a weekly visit to the library together. Even a few minutes of conversation while you’re cleaning up after dinner or right before bedtime can help the family catch up and establish the open communication that is essential to raising drug-free children.

MAKING YOUR POSITION CLEAR When it comes to dangerous substances like alcohol, tobacco, and other drugs, don’t assume that your children know where you stand. They want you to talk to them about drugs. State your position clearly; if you’re ambiguous, children may be tempted to use. Tell your children that you forbid them to use alcohol, tobacco, and drugs because you love them. (Don’t be afraid to pull out all the emotional stops. You can say, “If you took drugs it would break my heart.”) Make it clear that this rule holds true even at other people’s houses. Will your child listen? Most likely. According to research, when a child decides whether or not to use alcohol, tobacco, and other drugs, a crucial consideration is “What will my parents think?”

Also discuss the consequences of breaking the rules — what the punishment will be and how it will be carried out. Consequences must go hand-in-hand with limits so that your child understands that there’s a predictable outcome to his choosing a particular course of action. The consequences you select should be reasonable and related to the violation. For example, if you catch your son smoking, you might “ground” him, restricting his social activities for two weeks. You could then use this time to show him how concerned you are about the serious health consequences of his smoking, and about the possibility that he’ll become addicted, by having him study articles, books, or video tapes on the subject.

Whatever punishment you settle on shouldn’t involve new penalties that you didn’t discuss before the rule was broken — this wouldn’t be fair. Nor should you issue empty threats (“Your father will kill you when he gets home!”). It’s understandable that you’d be angry when house rules are broken, and sharing your feelings of anger, disappointment, or sadness can have a powerfully motivating effect on your child. Since we’re all more inclined to say things we don’t mean when we’re upset, it’s best to cool off enough to discuss consequences in a matter-of-fact way.

Contrary to some parents’ fears, your strict rules won’t alienate your children. They want you to show you care enough to lay down the law and to go to the trouble of enforcing it. Rules about what’s acceptable, from curfews to insisting that they call in to tell you where they are, make children feel loved and secure. Rules about drugs also give them reasons to fall back on when they feel tempted to make bad decisions. A recent poll showed that drugs are the number-one concern of young people today. Even when they appear nonchalant, our children need and want parental guidance. It does not have to be preachy. You will know best when it is more effective to use an authoritarian tone or a gentler approach.

Always let your children know how happy you are that they respect the rules of the household by praising them. Emphasize the things your children do right instead of focusing on what’s wrong. When parents are quicker to praise than to criticize, children learn to feel good about themselves, and they develop the self-confidence to trust their own judgment.

WHAT YOUR OWN ALCOHOL, TOBACCO, AND DRUG USE TELLS YOUR CHILDREN Drinking alcohol is one of the accepted practices of adulthood. It is legal for adults to have wine with dinner, beer at the end of a long week, or cocktails at a dinner party. But drinking to the point of losing control sends the wrong message to children, as does reaching for a drink to remedy unhappiness or tension.

Although it is legal for adults to smoke cigarettes, the negative impact tobacco has on a smoker’s health is well documented. If a child asks his parents why they smoke, they may explain that when they began, people didn’t understand how unhealthy smoking is and that once a smoker starts, it’s very hard to stop. Young people can avoid making the same mistake their parents did by never starting and risking addiction.

When parents smoke marijuana or use other illegal drugs, they compromise not only their children’s sense of security and safety, but the children’s developing moral codes as well. If you use illegal drugs, it is self-deluding to imagine that your children won’t eventually find out. When they do, your parental credibility and authority will go out the window. If their parents — their closest and most important role models — don’t respect the law, then why should they? Parents who abuse alcohol or other drugs should seek professional help. This help is available at treatment centers and from support groups such as Alcoholics Anonymous and Narcotics Anonymous. Their children also may benefit from professional counseling and support from groups such as Families Anonymous, Al- Anon, and Nar-Anon.

WHAT TO SAY WHEN YOUR CHILD ASKS, “DID YOU EVER USE DRUGS?” Among the most common drug-related questions asked of parents is “Did you ever use drugs?” Unless the answer is “no,” it’s difficult to know what to say because nearly all parents who used drugs don’t want their children to do the same thing. Is this hypocritical? No. We all want the best for our children, and we understand the hazards of drug use better than we did when we were their age and thought we were invincible. To guide our children’s decisions about drugs, we can now draw on credible real-life examples of friends who had trouble as a result of their drug use: the neighbor who caused a fatal car crash while high; the family member who got addicted; the teen who used marijuana for years, lost interest in school, and never really learned how to deal with adult life and its stresses.

Some parents who used drugs in the past choose to lie about it, but they risk losing their credibility if their children discover the truth. Many experts recommend that when a child asks this question, the response should be honest.

This doesn’t mean that parents need to recount every moment of their experiences. As in conversations about sex, some details should remain private, and you should avoid providing more information than is actually sought by your child. Ask clarifying questions to make sure you understand exactly why and what a child is asking before answering questions about your past drug use, and limit your response to that information.

This discussion provides a good opportunity for parents to speak frankly about what attracted them to drugs, why drugs are dangerous, and why they want their children to avoid making the same mistake. There’s no perfect way to get this message across, only approaches that seem more fitting than others. Some suggestions:

“I took drugs because some of my friends used them, and I thought I needed to in order to fit in. In those days, people didn’t know as much as they do now about all the bad things that can happen when you smoke marijuana or do other drugs. If I’d known then what I know now, I never would have tried them, and I’ll do everything I can to keep you away from drugs.”

“Everyone makes mistakes, and when I used drugs, I made a big one. I’m telling you about this, even though it’s embarrassing, because I love you, and I want to save you from making the same stupid decision that I made when I was your age. You can learn from my mistakes without repeating them.”

“I did drugs because I was bored and wanted to take some risks, but I soon found that I couldn’t control the risks — they were controlling me. There are much better ways of challenging yourself than doing drugs.”

“At your age, between homework, friends, sports, and other interests, there are a lot of fun things going on. If you get into taking drugs, you’re pretty much giving up those other things, because you stop being able to concentrate, and you can’t control your moods or keep to a schedule. You’ll miss out on all these great experiences, and you’ll never get those times back.”

“You don’t know how your body will react to drugs. Some people can get addicted really quickly and can get really sick even using a drug for the first time.”

“I started drinking/doing drugs when I was young, and I’ve been battling them ever since. They made me miss a big part of growing up, and every day I have to fight with myself so they don’t make me miss more — my job, my relationships, and my time with you. I love you too much to watch you set yourself on the same path.”

HOW GRANDPARENTS CAN HELP RAISE DRUG-FREE CHILDREN Grandparents play a special part in a child’s life and, unlike parents, grandparents have had years to prepare for their role. They’ve been through the ups and downs of child-rearing and bring a calmer, more seasoned approach to their interactions with their grandchildren. They, as well as other extended family members, can serve as stable, mature role models, especially if they need to step in to assume some of the responsibilities of the child’s parents.

These important elders have one advantage over parents: Their relationships with their grandchildren are less complicated, less judgmental, and less tied to day-to-day stresses. Grandparents can use their positions of trust and intimacy to reinforce the same lessons in self-respect and healthy living that children are learning from their parents. When grandparents show concern with questions like “Has anyone ever tried to sell you drugs?” or “Why are your eyes so red?” they may be more likely to hear honest answers — especially if they indicate that they are willing to listen in confidence, and will not be quick to judge or punish. Their grandchildren may be less defensive and more likely to listen closely to their advice about avoiding drugs. Grandparents can also help reinforce positive messages and praise their grandchildren when they do well.

OVERVIEW
As soon as your child begins to talk, the questions come: “Why is the grass green?” “What’s wrong with that man sitting in the park?” If you show your child that you’re ready to give answers at any time, even if the topics make you uncomfortable, you’ll forge a trusting relationship, and your child will feel comfortable coming to you with concerns because she knows you take her seriously.

Being a good listener also gives you insight into your child’s world. Your child will tell you about the sights and sounds that influence him every day — he’s the expert about fashion, music, TV, and movies that people his age follow. Ask him what music groups are popular and what their songs are about, what his friends like to do after school, what’s cool and what’s not and why. Encourage him with phrases such as “That’s interesting” or “I didn’t know that,” and by asking follow-up questions.

In these conversations, you can steer the talk to drugs and why they’re harmful. If you can ingrain this information in your children well before they are faced with making difficult choices, experts say they’ll be more likely to avoid rather than use. In fact, teenagers who say they’ve learned a lot about the risks of drugs from their parents are much less likely to try marijuana than those who say they learned nothing from them. You needn’t fear that by introducing the topic of drugs, you’re “putting ideas” into your children’s heads, any more than talking about traffic safety might make them want to jump in front of a car. You’re letting them know about potential dangers in their environment so that when they’re confronted with them, they’ll know what to do.

To introduce the topic, ask your child what he’s learned about drugs in school and what he thinks of them. He may even mention people who might be using them. If you hear something you don’t like (perhaps a friend smokes marijuana or your child confesses to trying beer at a party), it is important not to react in any way that cuts off further discussion. If he seems defensive or assures you that he doesn’t know anyone who uses drugs, ask him why he thinks people use them. Discuss whether the risks are worth what people may get out of using them and whether he thinks it would be worth it to take the risks. Even without addiction, experimentation is too great a gamble. One bad experience, such as being high and misjudging how long it takes to cross a busy street, can change — or end — a life forever. If something interrupts your conversation, pick it up the next chance you get.

TEACHABLE MOMENTS
Another way to talk about drugs is to take advantage of everyday “teachable moments”:

If you and your child are walking down the street and you see a group of teenagers drinking and hanging out, talk about the negative effects of drinking alcohol.

Newspapers are full of the consequences of alcohol and drug abuse. Take your examples right off the front page. Ask your child if she heard about the mother who used drugs and was arrested. Who will take care of her baby now? Did she make a good decision when she used drugs?

Watch TV with your children, and ask them what they think. Do the programs and advertising make drug use look acceptable and routine, or do they show its downside? When you see a news item involving drug use, point out the story’s full implications to families and all of society: Drug addiction can cause or aggravate many tragedies involving child neglect and abuse, family violence and rape, HIV transmission, teenage suicide, and teenage pregnancy.

WHEN THERE’S A FAMILY HISTORY OF ALCOHOLISM OR DRUG ABUSE
If your family had a tendency for high blood pressure, you’d tell your children they might inherit it. In the same way, they need to know about recurring patterns of substance abuse, particularly if you, your spouse, or their grandparents have had problems with alcohol or other drugs. Children of substance abusers are much more likely to become addicted if they use drugs; they may have inherited genes that make them react to alcohol and drugs differently, and they may have had more difficult upbringings. When you use the example of a family member to illustrate why your children should be careful about trying alcohol and other drugs, you make a compelling argument.

Try to find a positive perspective. If substance abuse is a persistent problem in your family, you might tell your children that being aware of the challenge that the future holds better equips them to plan ahead and avoid potentially unhealthy situations.

THE DRUGS IN YOUR KITCHEN CABINET
Ordinary household products such as nail polish remover, cleaning fluid, hair spray, gasoline, spray paint, and the propellant in aerosol whipped cream can be abused as dangerous inhalants. Inhalants pose a difficult challenge to parents because they can’t be banished from the household.

Because inhalants are easily available, they are a popular drug for younger users; more than one in five children report having used inhalants by the eighth grade, the year during which usage peaks. Parents need to tell children about the deadly consequences of abuse. Inhalants starve the body of oxygen and can cause unconsciousness, severe damage to the brain and nervous system, and even death.

HELPING YOUR CHILD SAY “NO” TO DRUGS
No matter where children grow up or who their friends are, nearly all of them are confronted at some time or another by friends with bad ideas — ways of testing limits, getting in trouble, and doing things they’ll regret later. It’s not so hard saying “No thanks, I have to go now” to a stranger. But it’s a lot tougher when a child’s friend — especially one whose approval means a lot to him — tries to get him to do something he knows is wrong.

Even “good kids” occasionally pester their friends into skipping a class or lying about why they were out together so late. But if friends or acquaintances entice your children to try tobacco, alcohol, or drugs, the consequences can be more serious. The best way to prepare children to succeed in these encounters is to “role play” — practice similar scenarios in advance. With the right words at the tip of their tongue, children can assert their independence while making it clear that they’re rejecting their friends’ choices and not the friends themselves.

You need to have these practice sessions before your child finds herself in any new situation. If your child hasn’t asked you what she should do in such situations, find the time to bring it up yourself. Stress that you’re working together on a skill that comes in handy whenever someone doesn’t want to take “no” for an answer.

You might, for instance, take the role of a boy she likes and try to persuade her to share a six-pack of beer with you. What can she say? “You’re such a jerk!” is alienating. “I don’t know…” leaves the door open and sounds like she could be coaxed. The middle ground, in which she’s firm but friendly, works best. Help her rehearse key phrases that give reasons for why she simply won’t have a beer:

“My parents would kill me if they found out, and they always find out!”

“No, I’m not into that stuff.”

“I tried it once, and I hate the taste.”

“My parents trust me to not drink, and I don’t want to break that trust.”

Or she could state the consequences of drinking:

“I tried it once and ended up vomiting on everything!”

“Drinking would make me feel out of control, and I hate that.”

She’ll need to be prepared for protests. She can meet them with the “broken record” technique, in which she repeats her reason for not drinking over and over until attempts at persuading her cease. Or she can make it clear that the discussion about beer is over by changing the subject: “Did you watch the basketball game last night?” or “Hey, do you know if that concert’s sold out?” If all else fails, she should leave the scene, saying, “I’ve got to go.”

WHY A CHILD USES DRUGS
Understandably, some parents of drug users think that their child might have been pressured into taking drugs by peers or drug dealers. But children say they choose to use drugs because they want to:

relieve boredom

feel good

forget their troubles and relax

have fun

satisfy their curiosity

take risks

ease their pain

feel grown-up

show their independence

belong to a specific group

look cool.

Rather than being influenced by new friends whose habits they adopt, children and teens often switch peer groups so they can hang around with others who have made the same lifestyle choices.

Parents know their children best and are therefore in the best position to suggest healthy alternatives to doing drugs. Sports, clubs, music lessons, community service projects, and after-school activities not only keep children and teens active and interested, but also bring them closer to parents who can attend games and performances. To develop a positive sense of independence, you could encourage babysitting or tutoring. For a taste of risk-taking, suggest rock-climbing, karate, or camping.

WHAT OUR CULTURE TELLS CHILDREN ABOUT DRUGS
Unfortunately, the fashions and fads that thrive in our culture are sometimes the ones with the most shock value. Children today are surrounded by subtle and overt messages telling them what is “good” about alcohol, tobacco, and drugs. Your children may see TV characters living in wealth and splendor off drug money, may stumble onto a website urging legalization of marijuana, may see their favorite movie stars smoking in their latest films, or may hear songs describing the thrill of making love while high.

To combat these impressions, sit down with them when they watch TV. Explore the Internet with them to get a feel for what they like. Anything disturbing can be turned into a “teachable moment.” You may want to set guidelines for which TV shows, films, and websites are appropriate for your child. (You also may want to reassure children that the world is not as bleak as it appears in the news, which focuses heavily on society’s problems.)

OVERVIEW
Speaking in an informed way about substance abuse, alcohol and cigarettes is the very chance in order to have honest and helpful two-way communication with your child, no matter what age he or she is.

PRESCHOOLERS
It may seem premature to talk about drugs with preschoolers, but the attitudes and habits that they form at this age have an important bearing on the decisions they will make when they’re older. At this early age, they are eager to know and memorize rules, and they want your opinion on what’s “bad” and what’s “good.” Although they are old enough to understand that smoking is bad for them, they’re not ready to take in complex facts about alcohol, tobacco, and other drugs. Nevertheless, this is a good time to practice the decision-making and problem-solving skills that they will need to say “no” later on.

Here are some ways to help your preschool children make good decisions about what should and should not go into their bodies:

Discuss why children need healthy food. Have your child name several favorite good foods and explain how these foods contribute to health and strength.

Set aside regular times when you can give your son or daughter your full attention. Get on the floor and play with him; learn about her likes and dislikes; let him know that you love him; say that she’s too wonderful and unique to do drugs. You’ll build strong bonds of trust and affection that will make turning away from drugs easier in the years to come.

Provide guidelines like playing fair, sharing toys, and telling the truth so children know what kind of behavior you expect from them.

Encourage your child to follow instructions, and to ask questions if he does not understand the instructions.

When your child becomes frustrated at play, use the opportunity to strengthen problem-solving skills. For example, if a tower of blocks keeps collapsing, work together to find possible solutions. Turning a bad situation into a success reinforces a child’s self-confidence.

Whenever possible, let your child choose what to wear. Even if the clothes don’t quite match, you are reinforcing your child’s ability to make decisions.

Point out poisonous and harmful substances commonly found in homes, such as bleach, kitchen cleanser, and furniture polish, and read the products’ warning labels out loud. Explain to your children that not all “bad” drugs have warnings on them, so they should only eat or smell food or a prescribed medicine that you, a grandparent, or a babysitter give them.

Explain that prescription medications are drugs that can help the person for whom they are meant but that can harm anyone else — especially children, who must stay away from them.

KINDERGARTEN THROUGH THIRD GRADE (5 — 8 YEARS OLD)
A child this age usually shows increasing interest in the world outside the family and home. Now is the time to begin to explain what alcohol, tobacco, and drugs are, that some people use them even though they are harmful, and the consequences of using them. Discuss how anything you put in your body that is not food can be extremely harmful. How drugs interfere with the way our bodies work and can make a person very sick or even cause them to die. (Most children of this age have had real-life experiences with a death of a relative or the relative of someone at school.) Explain the idea of addiction — that drug use can become a very bad habit that is hard to stop. Praise your children for taking good care of their bodies and avoiding things that might harm them.

By the time your children are in third grade, they should understand:

how foods, poisons, medicines, and illegal drugs differ;

how medicines prescribed by a doctor and administered by a responsible adult may help during illness but can be harmful if misused, so children need to stay away from any unknown substance or container;

why adults may drink but children may not, even in small amounts — it’s harmful to children’s developing brains and bodies.

GRADES FOUR THROUGH SIX (9 — 11 YEARS OLD)
Continue to take a strong stand about drugs. At this age, children can handle more sophisticated discussion about why people are attracted to drugs. You can use their curiosity about major traumatic events in people’s lives (like a car accident or divorce) to discuss how drugs can cause these events. Children this age also love to learn facts, especially strange ones, and they want to know how things work. This age group can be fascinated by how drugs affect a user’s brain or body. Explain how anything taken in excess — whether it’s cough medicine or aspirin — can be dangerous.

Friends — either a single best friend or a group of friends — are extremely important during this time, as is fitting in and being seen as “normal.” When children enter middle or junior high school, they leave their smaller, more protective surroundings and join a much larger, less intimate crowd of preteens. These older children may expose your child to alcohol, tobacco, or drugs. Research shows that the earlier children begin using these substances, the more likely they are to experience serious problems. It is essential that your child’s anti-drug attitudes be strong before entering middle school or junior high.

Before leaving elementary school, your children should know:

the immediate effects of alcohol, tobacco, and drug use on different parts of the body, including risks of coma or fatal overdose;

the long-term consequences — how and why drugs can be addicting and make users lose control of their lives;

the reasons why drugs are especially dangerous for growing bodies;

the problems that alcohol and other illegal drugs cause not only to the user, but the user’s family and world.

Rehearse potential scenarios in which friends offer drugs. Have your children practice delivering an emphatic “That stuff is really bad for you!” Give them permission to use you as an excuse: “My mom will kill me if I drink a beer!” “Upsetting my parents” is one of the top reasons preteens give for why they won’t use marijuana.

Teach your children to be aware of how drugs and alcohol are promoted. Discuss how advertising, song lyrics, movies, and TV shows bombard them with messages that using alcohol, tobacco, and other drugs is glamorous. Make sure that they are able to separate the myths of alcohol, tobacco, and other drug use from the realities, and praise them for thinking for themselves.

Get to know your children’s friends, where they hang out, and what they like to do. Make friends with the parents of your children’s friends so you can reinforce each others’ efforts. You’ll feel in closer touch with your child’s daily life and be in a better position to recognize trouble spots. (A child whose friends are all using drugs is very likely to be using them, too.) Children this age really appreciate this attention and involvement. In fact, two-thirds of fourth-graders polled said that they wished their parents would talk more with them about drugs.

GRADES SEVEN THROUGH NINE (12 — 14 YEARS OLD)
A common stereotype holds that teenagers are rebellious, are ruled by peer pressure, and court danger even to the point of self-destructiveness. Although teens do often seem unreceptive to their parents as they struggle to become independent, teens need parental support, involvement, and guidance more than ever.

Young teens can experience extreme and rapid shifts in their bodies, emotional lives, and relationships. Adolescence is often a confusing and stressful time, characterized by mood changes and deep insecurity, as teens struggle to figure out who they are and how to fit in while establishing their own identities. It’s not surprising that this is the time when many young people try alcohol, tobacco, and other drugs for the first time.

Parents may not realize that their young teens feel surrounded by drug use. Nearly nine out of ten teens agree that “it seems like marijuana is everywhere these days.” Teens are twice as likely to be using marijuana as parents believe they are, and teens are getting high in the places that parents think are safe havens, such as around school, at home, and at friends’ houses.

Although teens may not show they appreciate it, parents profoundly shape the choices their children make about drugs. Take advantage of how much young people care about social image and appearance to point out the immediate, distasteful consequences of tobacco and marijuana use — for example, that smoking causes bad breath and stained teeth and makes clothes and hair smell. At the same time, you should discuss drugs’ long-term effects:

the lack of crucial social and emotional skills ordinarily learned during adolescence;

GRADES TEN THROUGH TWELVE (15 — 17 YEARS OLD)
Older teens have already had to make decisions many times about whether to try drugs or not. Today’s teens are savvy about drug use, making distinctions not only among different drugs and their effects, but also among trial, occasional use, and addiction. They witness many of their peers using drugs — some without obvious or immediate consequences, others whose drug use gets out of control.

To resist peer pressure, teens need more than a general message not to use drugs. It’s now also appropriate to mention how alcohol, tobacco, and other drug consumption during pregnancy has been linked with birth defects in newborns. Teens need to be warned of the potentially deadly effects of combining drugs. They need to hear a parent’s assertion that anyone can become a chronic user or an addict and that even non-addicted use can have serious permanent consequences.

Because most high school students are future oriented, they are more likely to listen to discussions of how drugs can ruin chances of getting into a good college, being accepted by the military, or being hired for certain jobs. Teenagers tend to be idealistic and enjoy hearing about ways they can help make the world a better place. Tell your teens that drug use is not a victimless crime, and make sure they understand the effect that drug use has on our society. Appeal to your teen by pointing out how avoiding illegal drugs helps make your town a safer, better place, and how being drug-free leaves more energy to volunteer after school for tutoring or coaching younger kids — activities the community is counting on.

Your teenager may be aware of the debate over the legalization of marijuana and whether or not doctors should be able to prescribe it for medicinal purposes. The idea that there might be legitimate health advantages to an illegal drug is confusing. Now that your teenager is old enough to understand the complexities of this issue, it is important to discuss it at some point — perhaps during a teachable moment inspired by a news report. You may want to let your teen know that the ingredient in marijuana that has some medicinal value — delta-9- tetrahydrocannabinol (THC) — can already be prescribed by doctors in a pill form that doesn’t contain the cancer-causing substances of smoked marijuana. Other medical painkillers include codeine and morphine, both of which have been determined safe for prescription use after rigorous testing and review by scientific medical organizations.

It is important that parents praise and encourage teens for all the things they do well and for the positive choices they make. When you are proud of your son or daughter, tell him or her. Knowing they are seen and appreciated by the adults in their lives is highly motivating and can shore up their commitments to avoid drug use. Your teen may also be impressed by the importance of serving as a good role model for a younger brother or sister.

QUESTIONS CHILDREN FREQUENTLY ASK ABOUT DRUGS

Why would people want to put bad things into their bodies?
One answer might be that they might not realize how dangerous the bad things are; another is that they are not taking care of themselves. Sometimes people start using a drug just to see what it feels like, but it can turn into an addiction (like cigarettes) and it’s very hard to stop.

Why are some drugs good for you and some drugs wrong for you to take?
You can discuss how drugs are powerful chemicals that change the way you feel. Doctors prescribe medicine to make sick people better — these are “good” drugs. “Bad” drugs are ones that aren’t given by doctors and don’t make you better; in fact, they can harm your body. That is why it is wrong to take these “bad” drugs.

Why can’t I taste that “grown–up” drink?
A small amount of alcohol has a much greater negative effect on a child’s body than on an adult’s; even a small amount can sicken a child.

Did you smoke marijuana when you were young?
Don’t give your child more information than necessary. If the answer is “yes,” give the reasons why you feel you made a mistake; for instance, it made you feel out of control, you missed schoolwork, messed up in sports, let down your friends or lost touch with them. Also explain that more is known about the harmful effects of marijuana and other drugs now.

WHEN YOUR CHILD ENTERS MIDDLE SCHOOL OR JUNIOR HIGH
This year is both an exciting and challenging time for children. They’re little fish in a big pond and desperately want to fit in. Because your children may now see older students using alcohol, tobacco, and other drugs and may think they are cool and self-assured, your children may be tempted to try drugs, too. Drug use goes up dramatically in the first year of middle school or junior high.

No matter where you live, your children will be exposed to all kinds of drugs from now on, so you need to be familiar with all the information about drugs that they may be receiving. The names of drugs and methods of manufacture and ingestion change constantly, so look over the pictures of drugs, paraphernalia, and slang terms on the drug chart on pages 34-39. At this time when peer approval means everything, your children may make you feel unwelcome. But while your children are pulling away from you to establish their own identities or may seem to be embarrassed by you, they need you to be involved in their lives more than ever before.

To help your children make good choices during this critical phase, you should:

Make sure they’re well-versed in the reasons to avoid alcohol, tobacco, and drugs;

Get to know their friends by taking them to and from after-school activities, games, the library, and movies (while being sensitive to their need to feel independent);

Volunteer for activities where you can observe your child at school;

Get acquainted with the parents of your children’s friends and learn about their children’s interests and habits. If it seems that your child is attracted to those with bad habits, reiterate why drug use is unacceptable.

DRUG MYTHS VS. REALITY
While you are teaching the facts about drugs, your child is getting lots of misinformation and mythology from peers. Be aware and be ready to address the half-truths and misinformation that children hear and believe, such as:

Myth: Marijuana is not harmful because it is “all natural” and comes from a plant.

Truth: Marijuana smoke contains some of the same cancer-causing compounds as tobacco, sometimes in higher concentrations.

Myth: It’s okay to use marijuana as long as you’re not a chronic user or “stoner.”

Truth: Occasional use can lead to frequent use.

Myth: Because sniffing powdered heroin doesn’t require needles, it isn’t very risky (40% of the high school seniors polled do not believe there is a great risk in trying heroin).

Truth: Heroin is dangerous no matter how it’s ingested. Once addicted to heroin, users may eventually switch to injecting the drug because it’s cheaper.

Myth: Drugs are not that dangerous and I can handle it.

Truth: Drug use is extremely unpredictable and affects people differently. Anyone can become addicted to drugs.

Myth: Everyone is doing it.

Truth: Research shows that more than four out of five eighth graders have not used drugs in the past month. Even among high school seniors (the group with the highest rate of marijuana use), only a quarter of those polled in a national study reported using the drug in the last month. In any given school, most students aren’t doing drugs.

MEDICAL MARIJUANA UPDATE
If your teen is interested in the debate about whether or not marijuana should be legal in certain circumstances, you can state the facts: Voters’ referenda are appearing in some states to legalize marijuana for medical use.

Some supporters of medical marijuana are genuinely concerned with exploring the potential for providing sick people with relief from their suffering; others are using the issue to change drug laws in America and to legalize illegal drugs, principally marijuana.

To protect consumers, medical protocol is set by health authorities and not determined by popular vote. The Food and Drug Administration withholds approval of a drug until studies strongly indicate that it is safe and effective for its intended use. Unless such studies determine that marijuana used medically fits that description, the American Medical Association recommends that the drug not be prescribed or used for medical purposes.

TOBACCO AND TEENS: A BAD COMBINATION
Unfortunately, increased awareness about the hazards of tobacco smoking has not deterred many teens. In fact, the percentage of high school seniors who smoke has gone up since 1983. One reason may be that teenagers are notorious for not worrying about death — it seems a long way off. They may even convince themselves that by the time they’re adults, cancer and the other heart and lung diseases that smoking causes will be cured.

If you discover your son or daughter smoking, experts say you should tell him or her to quit immediately and that smoking is not tolerated. You need to be firm but supportive; let your child know you realize that breaking tobacco addiction is difficult for anyone, regardless of age. Understand that a child who is an addicted smoker may relapse and will need encouragement. Although relapses on the road to abstinence may recur, always make it clear that quitting is imperative. If your child can’t seem to quit independently, seek help from your family physician who may prescribe medication or direct your child to an anti-smoking program.

OVERVIEW
You already know about the dangers of illegal street drugs like marijuana, cocaine, and methamphetamine. But did you know that some teens are abusing legal products, like cough medicine, to get high? This page will provide the answers to many questions about cough medicine abuse, give helpful tips for preventing this and other types of drug abuse, and offer other resources for more information.

WHAT IS COUGH MEDICINE ABUSE?
Cough medicine abuse is taking extremely large doses of cough medicine to get high. The “high” is caused by taking a large amount of dextromethorphan, which is often abbreviated DXM, a common active ingredient found in many cough medications. This sort of abuse, whether it’s called cough medicine abuse, or dextromethorphan or DXM abuse, can be dangerous.

WHAT IS DEXTROMETHORPHAN?
Dextromethorphan is a safe and effective active ingredient found in many nonprescription, over-the-counter (OTC) cough medicines, including syrups, tablets, and gel caps. When used according to medicine label directions, the ingredient dextromethorphan produces few side effects and has a long history of safety. When abused in large amounts, it can produce a “high” feeling as well as a number of dangerous side effects.

WHAT ARE THE EFFECTS OF COUGH MEDICINE ABUSE?
The effects of abusing cough medicines containing dextromethorphan vary with the amount taken. Common effects when taken in large amounts include confusion, dizziness, double or blurred vision, slurred speech, loss of physical coordination, abdominal pain, nausea and vomiting, rapid heart beat, drowsiness, numbness of fingers and toes, and disorientation.

DXM abusers describe different “plateaus” ranging from mild distortions of color and sound to visual hallucinations, “out-of-body” dissociative sensations, and loss of motor control. Side effects can be worsened if the dextromethorphan-containing cough medicine being abused also contains other ingredients to treat more than just coughs. Cough medicine also is sometimes abused in combination with other medications, alcohol, and illegal drugs, which can increase the dangerous side effects.

To know if a product contains DXM, look for “dextromethorphan” in the active ingredient section of the OTC Drug Facts label. You also may look for an educational icon on the packaging of most OTC cough medicines containing dextromethorphan.

WHAT ARE SLANG TERMS FOR DEXTROMETHORPHAN?
The most common terms include Dex, DXM, Robo, Skittles, Syrup, Triple-C, and Tussin. Terms for using dextromethorphan include: Robo-ing, Robo-tripping, and Skittling, among others. Slang terms for dextromethorphan vary by product and region. Adults should be familiar with all of them.

HOW COMMON IS COUGH MEDICINE ABUSE?
Research shows that one out of 10 teens, or over two million teens, from across the country and of all backgrounds, has abused cough medicine to get high.

WHERE ARE TEENS FINDING INFORMATION ABOUT COUGH MEDICINE ABUSE?
Often, these teens find information about how to abuse cough medicine on the Internet. A number of web sites promote the abuse of cough medicines containing DXM. Some of these sites even recommend how much to take; suggest other drugs to combine with DXM; instruct how to extract DXM from cough medicines; promote drug abuse in general; or even sell a raw, unfinished form of DXM for snorting. Be aware of what your teen does on the Internet, the web sites he or she visits, and the amount of time he or she is logged on.

The abuse of cough medicine also now can be seen in some current music, movies, and fashion.

WHAT PARENTS CAN DO TO PREVENT COUGH MEDICINE ABUSE
Parents can make a positive difference in their teens’ lives, and research shows that parents do influence their teens’ decisions about whether to take drugs or not. To prevent DXM abuse specifically, the best advice is to educate yourself, communicate with your teens, and safeguard your medications.

EDUCATE YOURSELF

Educate yourself about cough medicine abuse and share this information with others who are in contact with your teen, such as school administrators, coaches, and counselors.

Know the signs of cough medicine abuse and what to watch out for.

COMMUNICATE WITH YOUR TEENS

Be clear that you do not want your teen taking medicine without your knowledge.

Teach your teens and younger children to respect medicines. Medicines are important tools in healthcare, but they must be used according to directions.

Make sure your teen understands that abusing cough medicine, just as using illegal drugs, can be very dangerous.

SAFEGUARD MEDICATIONS

Know what medicines are in your home and pay attention to quantities.

Keep all medications out of reach and out of easily accessible places like medicine cabinets.

If your child needs medications during school hours, speak with school officials about medicine policies in the school.

Monitoring is an effective way you can help your teen stay drug-free, and an important thing to do even if you don’t suspect your teen is using drugs. Monitoring means asking young people questions about where they’re going, what they’re doing, and with whom they’re spending time, as well as keeping tabs on their Internet use by using web browser tools and software designed to block certain sites. Put some of these tips to use, and your kids will benefit.

TALK WITH YOUR TEEN Teens who learn a lot about the dangers of drugs from their parents are up to half as likely to abuse drugs. Parents should talk often, listen regularly, and communicate clearly that they do not want their kids using drugs.

To talk credibly and effectively about the dangers of drugs, parents need to know what those dangers are. Teens know when they’re being lied to, so know the facts. To learn about the various drugs teens can abuse, including cough medicine, and the risks, visit the Partnership for a Drug-Free America at drugfree.org.

KNOW WHERE YOUR TEEN IS It’s important to know where your teen is and what he or she is doing. Research has shown that children without adult supervision are at significantly greater risk of truancy from school, stress, receiving poor grades, risk-taking behavior, and substance abuse.

INTRODUCE YOUR TEEN TO ADULT ROLE MODELS Find out what adult-supervised activities, like clubs or after-school sports, interest your teen and help get him or her involved. Connect with other adults who can help teens avoid the dangers of drugs, and reinforce the benefits of healthy, drug-free living.

KNOW YOUR TEEN’S FRIENDS Research from the Partnership for a Drug-Free America reports that more than half of teens say they have close friends who get high regularly. Parents need to know if these are the friends with whom their children are spending time. Keep tabs on their Internet use by using web browser tools and software designed to block certain sites. Put some of these tips to use, and your kids will benefit.

RECOGNIZE SIGNS YOUR TEEN IS USING DRUGS Parents don’t always recognize their kids might be using drugs. While it can be hard to know, there are some general warning signs you can watch for. The fact is, any teen could be using drugs, so stay alert. As a general rule, changes that are sudden or extreme may be a warning sign.

Signs your teen could be using drugs include:

Change in friends

Change in eating or sleeping patterns

Changes in physical appearance and hygiene

Declining grades

Loss of interest in hobbies or favorite activities

Hostile and uncooperative attitude

Unexplained disappearance of household money

Visits to pro-drug web sites

Empty drug or medicine containers or drug paraphernalia

Unusual chemical or medicinal smells on your child or in his or her room

HELPING A TEEN WHO IS USING DRUGS The goal is to prevent a drug abuse problem in the first place. If you fear, however, that your teen may have a problem, sit down with your child for an open discussion about alcohol and drug use. Openly voice your suspicions but avoid direct accusations. Do not have this conversation when your teen is under the influence of alcohol or other drugs, and make sure you sound calm and rational. Ask your teen what has been going on in his or her life. Discuss ways to avoid using alcohol and other drugs in the future. If you need help during this conversation, ask another family member, your child’s guidance counselor, or a physician.

Be firm and enforce whatever discipline you’ve laid out in the past for breaking house rules. You also should discuss ways your teen can regain your lost trust, such as calling in, spending evenings at home, or improving grades.

RESOURCES FOR MORE INFORMATION If you think your teen needs professional help, your doctor, hospital, or school nurse or counselor may be able to help. Or you can call 1.800.662.HELP or visit http://findtreatment.samhsa.gov, the treatment locator hotline and web site of the U.S. Substance Abuse and Mental Health Services Administration.

If you suspect a poisoning, call your local poison control center at 1.800.222.1222.

To learn more about drug prevention, visit the Partnership for a Drug-Free America at drugfree.org.

SIGNS THAT YOUR CHILD MIGHT BE USING DRUGS
Mood swings and unpredictable behavior are frequent occurrences for preteens and teenagers. While this can be symptomatic of hormone onset or another medical issue, it can also be a sign of drug or alcohol abuse. Warning signs can include:

Physical and Emotional

Withdrawn, depressed, tired, careless about personal grooming.

Sudden mood swings, increased irritability, personality change.

Eating or sleeping patterns have changed; up at night and sleeps during the day.

Hard time concentrating.

Eyes are red-rimmed, nose is runny in the absence of a cold, persistent cough, and/or change in complexion.

Slurred speech.

School, Social and Family

Hostile and uncooperative, frequently breaks curfews.

Inability to cope with problems and daily activities.

Thoughts of suicide.

Relationships with family members have deteriorated.

Has a new group of friends disinterested in standard family and social values.

Grades have slipped and/or attendance is irregular.

Has lost interest in hobbies, sports, and other favorite activities.

Recent disappearance of household money or other valuables.

The presence of pipes, rolling papers, small medicine bottles, eye drops, or butane lighters in your home signal that your child may be using drugs. Other clues include homemade pipes and bongs (pipes that use water as a filter) made from soda cans or plastic beverage containers. If any of these indicators show up, parents should start discussing what steps to take so they can present a united front. They may also want to seek other family members’ impressions.

ACTING ON YOUR SUSPICIONS
If you suspect that your child is using drugs, you should voice your suspicions openly — avoiding direct accusations — when he or she is sober or straight and you’re calm.

This may mean waiting until the next day if he comes home drunk from a party, or if her room reeks of marijuana. Ask about what’s been going on — in school and out — and discuss how to avoid using drugs and alcohol in the future. If you encounter reluctance to talk, enlist the aid of your child’s school guidance counselor, family physician, or a local drug treatment referral and assessment center — they may get a better response. Also explore what could be going on in your child’s emotional or social life that might prompt drug use.

Taking the time to discuss the problem openly without turning away is an important first step on the road to recovery. It shows that your child’s well-being is crucial to you and that you still love him, although you hate what he’s doing to himself. But you should also show your love by being firm and enforcing whatever discipline your family has agreed upon for violating house rules. You should go over ways to regain the family’s trust such as calling in, spending evenings at home, and improving grades.

Even in the face of mounting evidence, parents often have a hard time acknowledging that their child has an alcohol, tobacco, or drug problem. Anger, resentment, guilt, and a sense of failure are all common reactions, but it is important to avoid self-blame. Drug abuse occurs in families of all economic and social backgrounds, in happy and unhappy homes alike. Most important is that the faster you act, the sooner your child can start to become well again.

ADDICTION
No one who begins to use drugs thinks he or she will become addicted. Addiction is a disease characterized by compulsive drug-seeking behavior regardless of the consequences. Research conducted by the National Institute on Drug Abuse clearly shows that virtually all drugs that are abused have a profound effect on the brain. Prolonged use of many drugs including cocaine, heroin, marijuana and amphetamines can change the brain in fundamental and long-lasting ways, resulting in drug craving and addiction.

If and when a drug abuser becomes addicted depends on the individual. Research shows that children who use alcohol and tobacco are more likely to use marijuana than children who do not use these substances. Children who use marijuana are more likely to use other addictive drugs. Certain genetic, social, and environmental risk factors make it more likely that certain individuals will become addicted to alcohol, tobacco, and other drugs. These include:

children of alcoholics who, according to several studies, may have inherited genes that make them more prone to addiction, and who may have had more stressful upbringings;

sensation-seekers who may like the novelty of feeling drunk or high;

children with psychological problems, such as conduct disorders, who self-medicate to feel better;

children with learning disabilities, and others who find it difficult to fit in or become frustrated learning;

children of poverty who lack access to opportunities to succeed and to resources when they’re in trouble.

The more risk factors children have, the greater their vulnerability. And everyone has a different ability to tolerate drugs and alcohol — what if your child’s tolerance is very low?

Regardless of how “cool” drugs may look, there is nothing glamorous about the reality of addiction, a miserable experience for the addict and everyone around him. Addiction causes an all-consuming craving for drugs, leading an otherwise responsible, caring person to destroy relationships, work, and family life.

OVERVIEW
Parents do not need to feel they are alone in helping their children stay drug- free. For the first time ever, there are preventative intervention programs that have been proven to be effective and are available to schools, families and communities.

Children have the best prospects for leading healthy, drug-free lives when schools support parents in their anti-drug message. There should be nothing confusing or contradictory in what children learn about drugs from the adults in their lives, and school policies need to reflect the same attitude toward alcohol and drugs that you express at home: Drug use is not acceptable. Drugs diminish a child’s ability to concentrate and follow through on academic responsibilities, they cause loss of motivation and absenteeism, and students who use them can be disruptive and drain teachers’ time and energy. The best way to ensure that the anti-drug policies at your child’s school are strong is to be involved. You can:

Learn about the current policies regarding alcohol and other drugs at your child’s school. If there’s no anti-drug policy in place, attend PTA or curriculum review meetings, or schedule an interview with the principal to help develop a policy. The policy should specify what constitutes an alcohol, tobacco, or other drug offense, spell out the consequences for failing to follow the rules, and describe procedures for handling violations.

Familiarize yourself with how drug education is being taught in your child’s school. Are the faculty members trained to teach about alcohol, tobacco, and other drug use? Is drug education taught in an age-appropriate way at each grade level throughout the year or only once during a special week? Is drug education taught during health class, or do all the teachers incorporate anti-drug information into their classes? Is there a parent education component? Is the school’s program based on current research?

Immerse yourself in the school’s drug education program at home. Ask your child to show you any materials distributed during or outside class and take the opportunity to review them together.

Find out if your child’s school conducts assessments of its drug problem and whether these results are used in the program.

Ask what happens to those who are caught abusing drugs. Does the school offer a list of referrals for students who need special help?

Request and examine any existing materials. Do they contain a clear message that alcohol, tobacco, and other drug use is wrong and harmful? Is the information accurate and up to date?

Investigate whether your school’s drug program is being evaluated for success. Research indicates that some of the most effective programs emphasize the value of life skills such as coping with anxiety, being assertive, and feeling comfortable socially. When these lessons are combined with drug education and media literacy (being able to critically evaluate the media’s messages), students confronted with drugs are better equipped to resist them.

HELP FROM THE COMMUNITY
Drug-free sons and daughters not only strengthen their families but their communities, too. As a result, many towns have found ways to help local young people stay healthy. Some offer teens alternatives to familiar rituals, such as alcohol- and drug-free proms, and special dry events such as First Night festivities on New Year’s Eve. Others support student-run clubs where teens can hang out, listen to music, and play sports in the evening.

RECLAIMING OUR NEIGHBORHOODS BLOCK BY BLOCK
Contrary to a common misperception, drug-use rates for urban African-American children have typically been lower than rates for the population as a whole. But children in less affluent urban areas are more often exposed to drugs and the street-level drug culture. When dealers make themselves at home in a neighborhood, they often bring with them a number of other blights: crime, truancy, a higher drop-out rate, increased drug use, the physical deterioration of buildings and common areas, and despair. Residents, however, often don’t realize the tools at their command to discourage drug dealing. Dealers tend to avoid neighborhoods in which the community stands united against them. Here’s how we can demonstrate our commitment to reclaiming our streets:

Form a community patrol, block association, or Neighborhood Watch. Members can take turns patrolling the streets and recording license-plate numbers of cars cruising for drugs.

Increase two-way communication with the police by inviting them to neighborhood meetings and by keeping them informed about suspicious drug activities, which can be reported anonymously.

Fill the streets with volleyball games, block parties, and other events that make a strong, united showing to dealers.

Call the city public works department for help in cleaning up. Blazing lights, litter-free streets, and newly-planted flowers tell drug dealers that residents care too much about their neighborhood to hand it over.

Provide positive outlets for the energies of local young people so they won’t be attracted to drug-dealing — an activity that increases the likelihood that they’ll become users.

Continue to reassure our children that we love them and don’t want them to do drugs. Even in neighborhoods where a walk to the grocery store can mean exposure to a drug dealer, children whose parents reinforce strong anti-drug attitudes stand a better chance of growing up drug-free.

PARENTS SUPPORTING EACH OTHER
Parents have no stronger allies in their fight against drug abuse than each other. Many parents find it useful to meet regularly in support of each other. It’s helpful to be able to turn to other parents at the same stage of child-rearing with questions like “My daughter wants to go to a party where the chaperone will be a 20-year-old cousin — are you allowing your son to go?” If you haven’t met many parents in your area with whom you can share anti-drug plans, you might want to contact a parent or community group with resources for parents. These organizations also provide interested families with information about drug prevention and referrals for treatment.

No matter how good school and community anti-drug efforts are, a parent’s prevention campaign is still the most powerful. Gail Amato Baker, former president of Bowling Green Parents for Drug-Free Youth, who is now a community service representative for the Passage Group in Knoxville, Tennessee, tells why: “People often ask me why I think parents are the answer, and I think it’s because we have the most to lose. Schools can help, churches can help, law enforcement can help, but no one can replace the family. Being involved with drug and alcohol prevention lets our children know that we care. It strengthens the family and helps us to be the kind of parents our children need us to be.”

WHAT YOU CAN DO
Your child’s transition from elementary school to middle school or junior high calls for special vigilance. Children are much more vulnerable to drugs and other risky behavior when they move from sixth to seventh grade than when they were younger.

Continue the dialogue on drugs that you began when your child was younger, and stay involved in your child’s daily life by encouraging interests and monitoring activities. Use the specific actions below to significantly reduce the chance of your child becoming involved with drugs. Some of these actions, like being sure your child is supervised in the hours after school, may seem like common sense. And some may meet with resistance from preteens who are naturally striving to achieve independence from their parents. But all the measures listed below are critically important in making sure that your child’s life is structured in such a way that drugs have no place in it.

If possible, arrange to have your children looked after and engaged from three to five p.m. Encourage them to get involved with youth groups, arts, music, sports, community service and academic clubs.

Make sure children who are unattended for periods during the day feel your presence. Give them a schedule and set limits on their behavior. Give them household chores to accomplish. Enforce a strict phone-in-to-you policy. Leave notes for them around the house. Provide easy-to-find snacks.

Get to know the parents of your child’s friends. Exchange phone numbers and addresses. Have everyone agree to forbid each others’ children from consuming alcohol, tobacco, and other drugs in their homes, and pledge that you will inform each other if one of you becomes aware of a child who violates this pact.

Call parents whose home is to be used for a party. Make sure they can assure you that no alcoholic beverages or illegal substances will be dispensed. Don’t be afraid to check out the party yourself to see that adult supervision is in place.

Make it easy for your child to leave a place where substances are being used. Discuss in advance how to contact you or another designated adult in order to get a ride home. If another adult provides the transportation, be up and available to talk about the incident when your child arrives home.

Set curfews and enforce them. Weekend curfews might range from 9 p.m. for a fifth-grader to 12:30 a.m. for a senior in high school.

Encourage open dialogue with your children about their experiences. Tell your child, “I love you and trust you, but I don’t trust the world around you, and I need to know what’s going on in your life so I can be a good parent to you.”

TEEN CHALLENGE

Teen Challenge Southern California does not endorse any of the following outside products or services. The sources of information listed are intended only as a partial listing of resources. You are encouraged to research and inform yourself of the many additional products and services relating to drug and alcohol abuse available to you.

SUPPORT GROUPS

Alcoholics Anonymous World Services. A worldwide fellowship of sober alcoholics whose recovery is based on Twelve Steps. No dues or fees; self-supporting through small voluntary member contributions. Accepts no outside funds; not affiliated with any other organization. 475 Riverside Dr., New York, NY 10115; (212) 870-3400 nationwide, (212) 647-1680 in Manhattan. Website: http://www.aa.org/

Al-Anon Family Group Headquarters. A free, nonprofit, worldwide organization that supports and provides literature to family members and friends of alcoholics. 1600 Corporate Landing Pkwy., Virginia Beach, VA 23454-5617; (800) 344-2666 or (800) 356-9996. Website: http://www.al-anon.alateen.org/

Nar-Anon Family Group Headquarters. An organization that supports people who have friends or family members with drug problems. P.O. Box 2562, Palos Verdes Peninsula, CA 90274-8562; (310) 547-5800. Website: http://www.nar-anon.org/

National Council on Alcoholism and Drug Dependence, Inc. An organization that provides information, including literature and referrals on how to overcome alcohol and drug addiction. 12 W. 21st St., 7th Fl., New York, NY 10010; (212) 206-6770 or (800) NCA-CALL. Website: http://www.ncadd.org/

National Crime Prevention Council. An organization that works to prevent crime and drug use by providing parents and children with audio-visual materials, reproducible brochures, and other publications. P.O. Box 1, 100 Church St., Amsterdam, NY 12010; (800) 627-2911. Website: http://www.ncpc.org/

National PTA Drug and Alcohol Abuse Prevention Project. With the GTE Corporation, creators of “Common Sense: Strategies for Raising Alcohol and Drug-Free Children,” a new area of the National PTA’s Children First website (http://www.pta.org/). Focuses on learning the facts about alcohol and other drugs, setting clear limits for children, providing positive role models, and building strong bonds within the family and school. Program offers effective, easy-to-use ideas and materials, enjoyable games and activities. 330 North Wabash Ave., Suite 2100, Chicago, IL 60611-3690; (800) 307-4782 or (312) 670-6782. Website: http://www.pta.org/

National Institute on Drug Abuse. NIDA supports more than 85% of the world’s research on the health aspects of drug abuse and addiction. 5600 Fishers Lane, Rockville, MD 20857; (301) 443-1124. Website: http://www.nida.nih.gov/

Partnership for a Drug-Free America. An organization that works with the advertising industry to develop anti-drug public service messages and operates a comprehensive website for parents. 405 Lexington Ave., Suite 1601, New York, NY 10174; (212) 922-1560. Website: http://www.drugfree.org/